D二聚体和纤维蛋白原在口腔颌面部间隙感染中的表达及意义

Expression and significance of D-dimer and fibrinogen in patients with oral and maxillofacial space infection

目的:分析血浆D二聚体(DD)和纤维蛋白原(FIB)在口腔颌面部间隙感染患者中的表达水平和诊断效能。方法 :选择浙江大学医学院附属第二医院2019年1月—2019年9月住院治疗的口腔颌面部间隙感染(oral and maxillofacial space infection, OMSI)患者72例为病例组,同期选取无炎症的腮腺良性肿物患者77例为对照组,检测所有患者治疗前血浆DD、FIB、C-反应蛋白(CRP)和白细胞计数(WBC),分析DD、FIB与临床特征的关系。采用SPSS 20.0软件包对数据进行统计学分析。结果:OMSI患者血浆DD和FIB较非间隙感染患者显著增高(P<0.01);血浆DD和FIB升高与OMSI患者的住院时间显著延长(t=4.104,P=0.002;t=2.825,P=0.006)和术后需要ICU监护有显著相关性(t=2.305,P=0.024;t=5.675,P=0.000)。Logistic回归分析显示,两者升高均是导致OMSI患者住院时间显著延长(P=0.006,P=0.015)和ICU监护的危险因素(P=0.002,P=0.000);血浆DD和FIB可以联合CRP和WBC作为OMSI的诊断指标(DD:AUC=0.929;FIB:AUC=0.999)。结论:血浆DD和FIB可联合CRP和WBC高效准确地诊断OMSI,高水平DD和FIB是OMSI患者住院时间延长和术后需要ICU监护的重要参考指标。

PURPOSE: To analyze the expressions and diagnostic efficacy of plasma D-dimer(DD) and fibrinogen(FIB) in patients with oral and maxillofacial space infection(OMSI). METHODS: This was a retrospective cohort study that enrolled a sample of patients from January 2019 to September 2019. Seventy-two cases with OMSI were included in the experimental group, while 77 cases with benign neoplasm of the parotid gland were as the control group. SPSS 20.0 software package was used to analyze the levels of plasma DD, FIB, CRP and WBC before treatment in all subjects. RESULTS: Plasma DD and FIB levels in OMSI patients were significantly higher than those with non-space infections(P<0.05). Elevated DD and FIB levels were associated with prolonged hospitalizations in OMSI patients(t=4.104, P=0.002;t=2.825, P=0.006),and correlated with postoperative ICU(t=2.305, P=0.024;t=5.675, P=0.000), both of which were risk factors for prolonged hospitalization(P=0.006, P=0.015) and ICU monitoring(P=0.002, P=0.000). Plasma DD and FIB levels can be combined with CRP and WBC as diagnostic indicators for OMSI(DD: AUC=0.929, FIB: AUC=0.999). CONCLUSIONS: Plasma DD and FIB can be used to effectively and accurately diagnose OMSI in combination with CRP and WBC. Plasma DD and FIB levels are important indicators of prolonged hospitalizations and postoperative ICU in OMSI patients.